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Sunday, March 30, 2008

Acts of omission, when we could have acted to prevent a bad from happening at comparably low (or no) cost to ourselves, are arguably as morally reprehensible as if we had actively brought about the bad in question.

A bunch of religious nutters have killed their sick daughter thru an act of omission. Here's what happened, according to a report published in the Milwaukee Journal Sentinel, '11-year-old Madeline Kara Neumann died of diabetic ketoacidosis, a treatable though serious condition of type 1 diabetes in which acid builds up in the blood.' Why did she die? Well, she died due to an act of omission. Madeline's parents chose to pray for her recovery while shunning the idea of taking her simply to a doctor. So, while the parents and their nuttish church friends were busily organising prayer festivals (they requested fellow church goers to join their prayers while their daughter was dying), the teenager died a preventable death.

The Neumann's belong to an evangelical church that happens to subscribe to the view that God heals us and that if God doesn't heal us, it's our turn to hit the coffin.

'It was Sunday at 2:33 p.m. when Everest Metro Police said they first learned of the girl's condition. A call came into the dispatch center from a family relative who lived in California, said Police Chief Dan Vergin. Vergin said the relative notified authorities "that the child was ill, and due to religious reasons the family would not take the child to the hospital". Officers were dispatched to the home, and a second call - this time from the family's residence - was placed to 911, Vergin said. The caller said the girl was not breathing and did not have a pulse, Vergin said. Officers and emergency service personnel went into the house and found the girl in a family-room area lying on a futon mattress on the floor, Vergin said. "The mother and father were praying over her at that time," Vergin said.

According to doctors the girls would have been sick for about 6 months or so. The mother who, jointly with her husband prayed her daughter to death asked that the family be left alone in their grief.

I hope that nobody is going to leave them alone and that, after successful criminal proceedings, she and her praying husband will be locked up behind bars, where they're welcome to continue to pray for further miracles. Tis is all the more necessary as there is no insight on the parents side in their miserable failure to protect their daughter's life. Report the Milwaukee paper, 'They said it was the course of action they would take again," Vergin said. "They firmly believe even if they had taken her to a doctor, if this was the time God had chosen for her to die, she would die regardless of medical interference. This is not their defense, they aren't crazy people," Vergin added.

Savior that last sentence. Because these weirdos add 'God' to an otherwise ridiculous statement, some people seem to think they're not crazy. Just substitute 'flying spaghetti monster' for 'God', and ask yourself whether we would find that any more reasonable. After all, as some would say, it's possible that there's a God out there, but then, it could also be a flying spaghetti monster. In fact, the evidence for the existence of an all-powerful, omniscient, and 'good' flying spaghetti monster is as strong as that for the existence of God. For instance, there is an image (see top-left). So, it is possible that it exists and runs the universe!

Surely if the parents had explained their act of omission to consult a doctor with the suggestion that they're waiting for the flying spaghetti monster to heal their daughter we would have declared them insane. Why is there a special rule for that equally elusive thing called 'God'?

Tuesday, March 25, 2008

It seems in ongoing battles over crucial biomedical research involving human embryos as well as access to reproductive health services the UK government under Gordon Brown caved in to the Catholic Church's lobbying and threats. So, here's the deal, the Catholic crowd in government (several government ministers, including Opus Dei operative Ruth Kelly) threatened to defeat the 'Labour' government's new embryology bill. According to a BBC news report the Catholic Church's representatives on 'Labour's government benches are permitted to vote against these three partts of the bill in order to follow their conscience:

# Preventing fertility clinics from refusing treatment to single women and lesbians - under current legislation clinics must take account of the welfare of the unborn child including "the need for a father". This will be replaced by the "need for supportive parenting".# Creating a child with the correct tissue match to save a sick brother or sister.# Creating so-called hybrid animal/human embryos to aid stem cell research.

Good on them, at long last it will be possible again to make no bones of the Churches homophobic agenda when it comes to reproductive health services. No access to fertility clinics for lesbians in the UK. And, seriously, creating a child with the correct tissue match to save a sick brother or sister. How sickening a reason for creating a child! Now the Church succeeds in getting rid of the sick kid, and preventing the new child from coming into existence. I wonder whether such children, if given the chance to have a say, would mind coming into existence, helping their sibling to survive, and live happily ever after... - My hunch is, that they just might not mind!

The Church also demonstrated that it is dealing with the overpopulation issue inits very own way. Creating animal/human embryos for research purposes (we're looking a few days after 'conception', if you wish to use Catholic terminology), how truly Frankensteinian. The thought of having a cell mass of a few hundred cells of such hybrids makes me shiver. Soo they'd be taking over the world, no doubt! What's the big deal about seeing millions die of all sorts of degenerative diseases. Good on the Church. It seems its ongoing support of any pro-death and pro-disease agenda is cause for true celebration.

I have no doubt 'Labour' party voters will be delighted to find out that they actually voted the Vatican into office in the UK. Little did they probably know.

Thursday, March 20, 2008

The case of Ama Sumani is far from unusual. The 39 year old widowed mother of two died on Wednesday in Accra of cancer. What is unusual is how her preventable death was brought about by British immigration authorities. Ms Sumani went initially to the UK to further her studies but eventually fell ill. A bone marrow transplant would have preserved her life and prevented her premature death. Instead the British Home Office removed her from her hospital bed in Cardiff after her visa had expired, and put her on a plane back to Ghana. Ms Sumani, unsuprisingly perhaps, was unable to afford continuing private medical care in Ghana and eventually died, about 2 months after her forced return to Africa.

It goes without saying that the British Home Affairs ministry is unequivocal that it has followed procedure. Her visa expired, and medical care for her condition was available in Ghana. The immigration bureaucrats omitted to mention that minor snag, namely that Ms Sumani needed to generate a huge amount of money to pay for such medical treatment, because unlike in the UK in Ghana such care is not available thru its national health service. Not unusual in a two-tiered health care system. Everything is available - for a price. Miserable basic care exists for the overwhelming number of poor Africans and first class care for the continent's wealthy elites. So, Ms Sumani found herself in a situation not unlike very many Africans dying preventable deaths due to the lack of resources in their countries' health care systems - well, if whatever is in existence deserves the label ' health care system' to begin with.

The interesting ethical question is, of course, whether Ms Sumani deserved to be given compassionate leave of stay in the UK, and with that the right to receive continuing free care in that country's public health care system. This question, it goes without saying, is relevant not only to the case of Ms Sumani and not only to the UK, but equally to Canada, Australia and many other countries at the receiving end of medical migrants from the developing world. Why should we pay for the health care of impoverishes migrants from developing countries?

Well, for starters, because we can. The reality today is that our health care systems are able to absorb the comparably small number of medical migrants from developing countries suffering life-threatening illnesses. We could comfortably afford to resource our health care systems such that these additional patients won't break the proverbial camel's back. It's not unreasonable to suggest that we are morally obliged to act to prevent harm from happening if it is within our means to do so, and if the costs we have to bear are comparably small.

There is a second good reason: Only about 18% of the world's doctors and nurses reside in developing countries. We developed world people continue to recruit health care professionals that were initially trained in the developing world. About one out of every five Africa-born medical doctors works today in the developed world. The rich, in other words, are free-riders depending to some extend on a continuing transfer of health care professionals from the developing to the developed world. Developing countries use their resources to train very many of our doctors and nurses. Ghana, the country of which Ms Sumani was a native citizen has only about 6 doctors for every 100,000 citizens. It lost 3 out of every 10 Ghana-educated doctors to the US, UK, Canada, and Australia.

Perhaps we should consider offering free care to medical migrants that make it to our shores as one possible means to compensate the developing world for our continuing complicity in the stripping of their fledgling health care systems of health care professionals.

Wednesday, March 19, 2008

French woman Chantal Sebire died at the age of 52 at her home near Dijon. Sebire suffered from a rare form of cancer that disfigured her entire face, eventually robbing her of her eyesight, capacity to smell, and that left her in severe pain.

Sebire campaigned during her last months for her right to died a death with dignity, in other words, she requested that France permit her doctors to help her die. Voluntary euthanasia as well as any other form of euthanasia is illegal in France, hence her request was denied. As the court in Dijon, in rejecting her plea pointed out, 'Even if the physical degeneration of Madame Sebire merits compassion, this request can only be rejected under French law.'

As Ms Sebire pointed out, 'One would not allow an animal to go through what I have endured.' The BBC reports, 'Legislation adopted in 2005 allows families to request that life-support equipment for terminally ill patients be switched off, but does not allow a doctor to take action to end a patient's life.'

Yet another example where zealot pro-life legislation trumps the decisions of competent individuals who make a voluntary decision to end their lives when they see fit. Sebire is right, we would not permit an animal to be treated as she was. She mentions that children eventually ran away from her when she walked in the streets of Dijon, while she was still capable of doing so. A truly tragic case.

Tuesday, March 18, 2008

Students in most countries today pay tuition fees. Even countries that took great pride in their public universities (like Australia, Germany and the UK)started quietly with smallish top-up fees, higher education contribution schemes or whatever their euphemism for charging higher education students for their education might have been. Fees went up and up and up ever since. It goes without saying that people from poorer families face ever higher hurdles in their attempts at accessing higher education. They'll either often be unable to afford steep up-front fees, or the thought of gigantic student debts will put them off higher education forever. There are all sorts of rationales, some less rational than others, for why these fees were and are supposedly necessary.

It's probably worth noting that in each of the countries mentioned they were introduced by a generation of politicians that themselves benefited from tuition free access to university. Probably a phenomenon similar to that miserable little black man on the US Supreme Court, Clarence Thomas. A beneficiary of affirmative action policies if there ever was one, he now spends most of his time on turning back the clock on affirmative action (as well as civil rights like reproductive rights of women). I digress, I apologize.

Now, given that students pay ever more and more, and end up with ever higher debts when they graduate - let's ignore those scholarship receiving students attending investment banks with a little bit of education attached to them, like Harvard University, Princeton and other elitist outfits - it seems worth asking, why students continue to study for degrees in the arts and humanities, given that such degrees are not exactly leading to straightforward money-printing-press-equivalent degrees as law and medicine degrees , or even engineering degrees do.

Well, and here is the surprising finding from Great Britain: It is so, because only 35% of students polled in the UK declared that their primary reason for studying what they studied was the job prospects. 38% declared that they studied what they studied because of their love for the subject of their course. (This, of course includes people for whom their choice of study subject is both a subject that they love, and a subject that they chose because of job prospects.) That I find surprisingly reassuring.

Despite various governments' efforts to eliminate anything to do with culture from universities (by starving the arts and humanities of funding for research and teaching), our new 'customers' voted with their feet and elected to study arts and humanities subjects anyway. Many young people seem to have decided that universities are not merely educational factories designed to offer glorified vocational training and pseudo-academic degrees like Master's degrees in jeans design and similar such nonsense.

It is fair to say that academics have failed in most countries pretty miserably in defending the academy against the onslaughts of those aiming to transform universities into vocational training outfits. Students' love for the subjects they choose are probably one of the reasons for why arts and humanities continue to thrive these days, despite all the dooms-day sayers.

Tuesday, March 11, 2008

The skipper of the P&O ocean liner Oceana had it with those Germans. I'm sure you have heard (and possibly endured) it all before: se (soft 's', try it yourself to get in the right mood) Germans did it again. The Oceana was trundling thru the Caribbean while the islands in that part of the world were in-between their usual devastating hurricane seasons. And what did se Germans do? Well, according to Christopher Wells, the captain of the ship, they blocked the sun loungers with towels to ensure that passengers from other countries (well, let's just say, other passengers - period) could not take occupation of the 'best' spots on the ship while they're still having breakfast. Christopher Wells, himself married to a German woman, had enough of it and scolded se Germans thru the ocean liner's speaker system. He introduced a new pre-emptive rule, saying in effect that a sun lounger that isn't occupied by a suitably overweight, pink to red body (I'm making these qualifications up...) for 20 minutes could be taken over by another suitably overweight, pink to red body. It goes without saying that people started taking positions next to popular sun loungers with stop watches in order to take them over in case someone left their (sorry, NOT any longer their) lounger unoccupied for more than the permissible time. According to newspaper reports people soon started fighting over the reading of their timepieces and came close to exchanging blows. None of this surprises me, after all, they were all imprisoned on a big ship and probably had nothing much else to do. There's only so much buffet you can do ...

Anyway, what fascinates me about this really is that in an instant the captain had se Germans identified as the offending culprits. Anyone who has ever read British newspapers of the right wing variety (like the Telegraph) or the red masthead variety (like the Mirror or Sun) will have read stories about se Germans occupying beach and pool spots with their towels or other paraphernalia to ensure a good spot in the sun. After all, the fight fundamentally is about a place guaranteeing to maximize the occupiers chances of getting skin cancer, and according to these reports se Germans are kinda good at that.

Well, I was born in Germany... and I never jostled for these sorts of spots. In fact, and this might surprise you, too, I met the other day a Jamaican guy who hasn't killed anyone and isn't a drug dealer. Incredibly as it may sound, there's even the odd Iranian out there who thinks it might be sensible not to stone gay folks to death. I even bumped into a Japanese woman who just can't stand sushi. So, why are we so busily stereotyping people who happen to have been born (by accident, let's face it) in whatever part of the world? It just does not make much sense (just about ever) to talk about 'the' Americans, or 'se' Germans, so why don't we all grow up and move on ('all' here stands for folks who stereotype people seriously in that manner).

I sometimes wonder how sophisticated aliens from another galaxy would look at us busybodies that are working day and night to show how hugely different we all are from one another. Quite conceivably they wouldn't even understand what we are on about... we carbon based life forms.

Sunday, March 09, 2008

I love Sony's TX series notebooks. They cost a bundle (my TXN27CN cost a bit less than 3,000 $), but you get fantastic hardware. The battery lasts for a very long time, the screen is plain brilliant, and it is really light in terms of its weight. What drives me bonkers, however, as with any of the other vaios i had, is that the silver desktop colour peels off in absolutely no time. This h as happened to me with every Vaio I ever owned (and there have been a few over the years). Makes me wonder what's wrong with the bean counters at Sony. I wonder whether it's worth putting people off who pay a huge premium for their premium hardware by way of adding cheap paint on the desktop.

Monday, March 03, 2008

According to conservative estimates between 2-4% of hospital patients fall victim to doctors’ mistakes. In Germany every year between 340,000 and 680,000 patients are affected by such errors. At least 17,000 patients die in that country each year because of doctors’ errors. Compare that to the about 5,000 people who die in Germany in traffic accidents per year. No doubt, sub-optimal health care is a dangerous business. Equally, though, mistakes are all too human. They are obviously of greater consequence in some professions than in others.

W Five’s investigative team broadcasted last Saturday allegations about professional failings of a surgeon at Scarborough General Hospital. Some of these allegations seem to have been well-founded, because the surgeon in question is these days restricted in terms of the work he is able to perform at the hospital. The program makers went further. They demanded that patients should be able to access individual surgeons’ records of success and failure rates. After seeing the program and listening to truly heart-wrenching stories, anyone’s gut feeling would likely be that such disclosure is not unreasonable. After all, wouldn’t we all want to improve our odds if we had to undergo surgery? Surely, none of us would volunteer knowingly to be operated on by the worst-performing surgeon of any hospital department, or would we?

The ethical argument underpinning this demand is essentially that for any patient to give truly autonomous informed consent to any medical procedure she needs to know anything that is reasonably material to informed decision-making. One could argue that information about a given doctors’ failure rates is very much materially relevant to informed decision-making. Admittedly, a reasonable person likely would want to know. And yet, I remain skeptical about this solution. It seems, once we were to receive such information we would be sliding down a slippery slope that strips our health care professionals of much of the same rights to a kind of professional type of privacy that we take for granted for ourselves. Why not ask our doctors to also disclose any health problems they might have that might pose a risk to us during surgery? Do they suffer from infectious illnesses (we might not trust the efficacy of universal precautions)? Should we not test them prior to surgery and display that information on posters throughout the hospital and on the internet? Should we enforce psychological testing prior to surgery to ensure that no spousal dramas affect the on- the-job performance? Why not also have public report cards on the maintenance of the hospital equipment, cleanliness and so on and so forth? There does not seem to be a clear line that can be drawn in the sand on this issue, once we start going down the track proposed by W Five’s investigative journalists.

When we board a train, do we expect displays indicating how often the train driver erred during his career? Do we check when we board a transatlantic flight how old the plane is, or whether the pilot and captain have a history of heart problems? Most of us don’t bother undertaking such detective work, and we don’t expect such information to be reasonably available to us. Nothing less, however is being proposed for doctors. When you think about planes and pilots (indeed, bus drivers!) many more lives are at stake, yet our inquisitive minds are at peace in the knowledge that regulatory agencies will ensure that the bus driver is well trained, and that the equipment she uses is in top condition. Government and statutory bodies like the Ontario College of Surgeons and Physicians look after the quality of our doctors and have checks and balances in place that ensure that individual professionals failing us are found out and properly dealt with. So it should be. This much the professions and our professionals owe us as society. The real issue then should arguably not be to keep publicly track of individual performances, but to ensure that hospitals act fast when individual professionals’ performances are suboptimal. Scarborough General Hospital clearly failed on this count, if the information on the W Five program is to be trusted. It is also worth asking how we can ensure that the College of Surgeons and Physicians moves faster than it has in the case highlighted on W Five. It is a perennial problem of such bodies the world all over that many citizens and indeed, many professionals think that they are more concerned to cover up for colleagues under scrutiny then to keep the interests of individual patients, clients and society at large at heart. This constitutes a serious threat to the professions and the trust society has invested in them. It is government’s responsibility to ensure that institutions like the Ontario College of Surgeons and Physicians deliver on that front, and do so in a transparent manner.

The current demands for the public availability of individual doctors’ performance data are missing the point. Patients should not ever find themselves in a situation where such data would make a difference, because the offending professionals should be out of their jobs way before that information would be on display. That is the real regulatory issue.

Saturday, March 01, 2008

Eish, this is neat. I was on my usual daily shopping trawl on the net to pick up basic health care items, you know, like cancer treatments, viagra, also something against schizophrenia. And, it's not easy at all, to get the necessary equipment or drugs that can help with those issues. Fair enough, viagra is the easiest bit, but still, tad bit pricey, so I naturally shop for serious discounts.

Comrade Kim Jong Il, the current paramount leader of the great great nation of the Democratic Peoples Republic of Korea, also known as North Korea, has been painfully aware of my unsuccessful searches and decided to do something about them. He set up a commercial website featuring state of the art health care products that will be able to deal with the ailments just listed, as well as many others. In fact, the stuff they're selling is so brilliant that some of of the products deal with a whole range of diseases in one go. I cannot recommend them highly enough to you. My personal favorite is the Portable Semiconductor Laser Curer. This amazing health care tool is a laser, basically, but this one cures. What you got to do is to plug it into one of your nostrils and simply laser into the opening for something like 15 min (make sure the battery is fully charged, of course). If you do that, it'll cure for you, and I quote, 'treatment of stenocardia, hypertension, diabetes, cerebral thrombosis, cerebral haemorrhage, schizophrenia, bronchial asthma and canker'. I'm sure it's just a typing error and they meant to say 'cancer'. I tried it, and I can tell ya, ever since I started using it I didn't get cancer, so it seems to be a decent prophylactic, too. My diabetes is also gone, my asthma is seriously retreating, but my schizophrenia takes a while longer to fix it seems (I secretly increased the treatment from Monday this week to 20 min, so I'm sure I'll be cured of that problem, too).

Another tool will be of great interest to geologists and all those of us suffering from the 'harmful influence of transient geomagnetic variations', which causes things like 'hypertension, cerebral thrombosis, neuralgia, inflammation, diarrhea, insomnia, constipation, etc'. I understand that etc means anything those transient geomagnetic variations have caused you. So, the top scientists in North Korea have developed a truly fantastic tool, the Portable Magnetic Treater! Thank goodness for that! All you got to do is press it on the spot where the pain occurs until the pain is gone. I tried it the other day on the spot where my leg was amputated fairly recently, and guess what, it grew back over night. Amazing stuff. Just remember to press the Portable Magnetic Treater on the spot that causes you problems. The etc means it'll help you whatever the problem. I just luv this piece of hi-tech equipment. True genius.

Sadly tho my erectile dysfunction issue cannot also be resolved with that same laser. I pressed the Portable Magnetic Treater for a long time, but no, it seems the etc didn't cover that irksome problem. Bummer. But there's help on the website. Amazing product, it's called Neo-Viagra-Y.R. Like all the other website products it deals with all sorts of problems in one go. This one is particularly cool, and should prove quite helpful to all those of us that are getting on in their years. Especially if our partners are a bit on the tiresome end of things. What this product does, as I said, among many many other things, is to prolong sexual intercourse. So, if you take it, it's not just that you can go on and on and on, but that you will go on and on and on. Again, pretty amazing stuff. You got to control yourself, obviously, because at one point you just got to stop and eat a bit, watch may be the news, sleep occasionally, things like that. The good news is, if the prolonged sexual activity this product triggers causes you a stiff shoulder (no pun intended), Neo-Viagra-Y.R. helps with that problem, too. Of course, you could also deploy the Portable Magnetic Treater. The choice is entirely yours. That's the nice thing about these multi-functional products!

By the way, if you decide to go to that website you will also discover something pretty shocking about capitalism. At the moment at least the Great Leader offers us incontrovertible evidence (photo in top right-hand corner) that the old Mercedes E Class actually isn't the old Mercedes E Class, but a North Korean limousine called 'Junma'. These German bastards really dared to steal the design of the Junma. Pretty incredible stuff! I'm glad that information is in the open now!

And, if you think, only the North Korean leaders are somewhat nuts, which no doubt they are, there's usually good company for them among the ranks of the South African government. On the same level of idiocy as the portable laser curer is that country's Minister for the Optimal Prevention of Health (MOPH), Manto Tshabalala Msimang. Just to remind the world that she still exists and is up to no good, Manto decided that African traditional medicine doesn't have to prove itself according to the scientific method. She said, 'We cannot use Western models of protocols for research and development. We should guard against being bogged down with clinical trials.' Indeed, and there's a good reason for this, according to Manto 'some of the medicines have been used by traditional healers for thousands of years..'

Quod erat demonstrandum! Now we know indeed.

ADDENDUM 02/03/08: My friend Ray Smith tells me that canker actually exists, so perhaps the laser curer really is meant to deal with canker and not cancer and I got it all wrong :).